Until three months ago, 80-year-old Kiran Shah would run out of breath even if he walked just 15-odd steps. A diabetic patient with high blood pressure, below normal kidney functioning, and a pacemaker, he was suffering from aortic stenosis (narrowing of aortic valve) and the family members were exploring treatment options for him.
The family happened to meet Dr. Abhishek Rajpopat, interventional cardiologist and an expert in structural heart diseases. Medicines do not work in case of aortic stenosis and open heart surgery or Transcatheter Aortic Valve Implantation (TAVI) are the only options.
Trained at Copenhagen, Denmark, Dr. Rajpopat opted for zero contrast TAVI or Transcatheter Aortic Valve Replacement (TAVR).
He told THE WEEK on Tuesday that in Shah’s case administering contrast media (a chemical used to see with clarity the structures within the body) during the procedure could have posed severe threats to the already compromised kidneys, potentially leading to kidney failure. “To mitigate this risk, I opted for a contrast media-free approach,” he said.
According to Dr. Rajpopat, performing the procedure without contrast media requires specialised and exceptional level of skill and a specialsed team. "It is like driving a car in the night without a headlight," he explained.
It has now been three months since Shah underwent the procedure, which, Dr Rajpopat said, has been the first of its kind in the western region on a patient of Shah’s age.
Shah’s son Kunal said they were informed about the risk factors and given his father’s complications, they opted for TAVI over open heart surgery. In patients over 80 years of age, the mortality rate is around 0.5 per cent to 0.8 per cent.
While Shah’s regular medicines would continue, for the heart all that he now requires is blood thinning medicines.
“I am feeling really good. I do not need anyone’s help in my daily routine,” Shah said.
“Times are changing and so is life expectancy. You are never too old and sick to be treated,” Dr. Rajpopat concluded.